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Pills over Therapy? From a Psychotherapist to Prescription-therapist. Sounds like another big business…all about the Money rather than the HUMAN being :(

Posted on: March 9, 2011

The practice of psychiatry has become more and more about limited (15 minute) consultations with patients with the principle aim of consulting about psychiatric medications and refilling prescriptions, a far cry from the image of earlier days when patients, stretched out on couches, elaborated about their anxieties to bewhiskered doctors seated in leather armchairs. One reason behind the change, according to the New York Times, is insurance companies, which reimburse 45-minute talk therapy sessions at a lower rate than the 15-minute ones to refill prescriptions.

A psychiatrist can earn $150 for three 15-minute medication visits but only $90 for a 45-minute talk therapy session. Psychologists and social workers (who don’t attend medical school and ‘can often afford to charge less’) can also provide talk therapy. There’s no evidence that talk therapy provided by psychiatrists is of better quality.

The New York Times article profiles a psychiatrist, Dr. Donald Levin, who runs a private practice in Doylestown, Pennsylvania. Dr. Levin works 11 hour days and sees 40 patients a day. Initial consultations are for 45 minutes, with the following visits lasting for 15 minutes. Dr. Levin’s wife runs the business side of his practice with a set fee schedule for patients: $50 for a missed appointment, $25 for a faxed prescription refill and $10 extra for a missed co-payment. In those short sessions,

Dr. Levin asks for quick updates on sleep, mood, energy, concentration, appetite, irritability and problems like sexual dysfunction that can result from psychotropic medications.

“And people want to tell me about what’s going on in their lives as far as stress,” Dr. Levin said, “and I’m forced to keep saying: ‘I’m not your therapist. I’m not here to help you figure out how to get along with your boss, what you do that’s self-defeating, and what alternative choices you have.'”

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